Can I Have A Lower Jaw Advancement Done After Having Had A Sliding Genioplasty Done?

Q: Dr. Eppley,  I had a chin advancement done several months ago due to my severe lower jaw deficiency.  I just want to ask a question. I definitely feel there has been an improvement since having the chin moved, but I was wondering what your opinion is on whether moving my jaw itself would ever be possible in my case because I still feel that my lower jaw deficiency is problematic.   I would assume as an oral surgeon it is a procedure you are familiar with.   I have had a lot of dental work done which definitely complicates things unfortunately, but the appearance of my lower jaw is still something that bothers me.   I am currently 24 years old and have been bothered by it tremendously for years now.  I do realize that jaw surgery is very costly unfortunately, but the financial realities aside, I just wanted to hear your opinion about whether it even is a possibility given the dental work I have had done in your opinion.  I definitely regret not taking better care of my teeth and would do it all over again if I could because of how much of a toll this problem has taken on me.

A: In looking at your x-rays, you do have an overall lower jaw deficiency with a Class II malocclusion. Your indwelling dental work aside, the question of whether you could ultimately have a sagittal split mandibular advancement first requires an orthodontic opinion. Such orthognathic surgery requires a period of orthodontic preparation and after surgery orthodontic fine tuning. While I suspect you are an orthodontic candidate, how much time that would require and the associated costs would have to be answered by an orthodontic evaluation. This orthodontic process is the rate-limiting step for any patient considering orthognathic surgery as the jaw(s) can not be moved without it in place and having the teeth realigned for such surgery. As an cosmetic camouflage alternative, that is why you have a chin osteotomy initially.

Dr. Barry Eppley

Indianapolis, Indiana